低剂量多层螺旋CT肺癌检出的影像学特点  

Imaging Features of Lung Cancers Detected By Low-Dose Helical Computed Tomography

作　　者：褚志刚[1] 杨志刚[2] 欧阳羽[1] 

机构地区：[1]重庆医科大学附属第一医院放射科,400016 [2]四川大学华西医院放射科,成都610041

出　　处：《临床放射学杂志》2014年第12期1850-1854,共5页Journal of Clinical Radiology

基　　金：重庆市科委基金资助项目(编号:cstc2014jcyjA 10067)

摘　　要：目的探讨低剂量CT筛检出的肺癌的影像学特点。方法连续性搜集接受胸部低剂量CT肺癌筛查者资料13099例,其中男8362例,女4737例,年龄40~105岁,平均（52±10）岁。对可疑肺癌者进行随访复查,着重分析确诊肺癌的影像学表现。结果 13099例中,可疑肺癌者73例（0.56%）,共发现肺结节[（结节大小=（长径＋短径）/2]及肿块（大小〉3 cm时称之为肿块）共74个,平均大小为2.1 cm（范围0.8~8.1 cm）,其中非实性、实性、混合性结节及混合性、实性肿块病灶分别为16（21.6%）、21（28.4%）、19（25.7%）、5（6.8%）、13（17.6%）个。73例中,61例（83.6%）证实为肺癌,其中49例共发现癌结节50个,中央型者11个（22%）,周围型者39个（78%）,平均大小为1.6 cm（范围0.8~2.9 cm）,组织学类型为鳞癌者4例（8.2%）,腺癌者44例（89.8%）,小细胞肺癌者1例（2.0%）;CT表现为Ⅰ~Ⅵ型病灶者分别为15（30%）、10（20%）、4（8%）、7（14%）、4（8%）、10（20%）个;所有癌结节中,合并有内部及边缘征象者明显较无合并征象者大（1.9 cm vs.1.2 cm,P〈0.001）。结论低剂量CT筛查检出的肺癌中结节明显较肿块多见,癌结节的CT表现具有一定的特征性。Objective To investigate the imaging features of lung cancers detected by low-dose helical CT scanning in order to improve the understanding of early lung cancers. Methods A total of consecutive 13099 patients who had received low-dose helical CT screening were collected. The patients included 8362 males （63. 8% ） and 4737 females （36.2%） with a mean age of （52 ± 10） years （ range 40 - 105 years）. The patients with suspected lung cancer were followed up. The imaging features of the nodules and masses which turned out to be lung cancer were analyzed. Results Among the 13099 subjects, suspicious lung cancer was considered in 73 （0.56%）, and a total of 74 nodules （ 〈 3 cm） and mass （ 〉 3 em） were detected, the mean diameter of the lesions was 2.1 em （ range 0.8 - 8.1 cm）. The 74 lesions ineluded 16 （21.6%） non-solid nodules, 21 （28.4%） solid nodules, 19 （25.7%） mixed nodules, 5 （6.8%） mixed masses and 13 （ 17.6% ） solid masses. Of the 73 cases, diagnosis of lung cancer was confirmed in 61 （83.6%）, among them a total of 50 cancer lesions were detected in 49 cases, including central lung cancer （n = 11, 22% ） and peripheral lung cancer （ n = 39, 78% ）, and the mean diameter was 1.6 cm （ range 0.8 - 2.9 cm）. Pathologically, squamous cancer was seen in 4 cases （8.2%）, adenocarcinoma in 44 cases （89.8%） and small cell lung cancer in one ease （2.0%）. CT scanning demonstrated that type Ⅰ, Ⅱ, Ⅲ, Ⅳ, Ⅴ and Ⅵ of lung cancer was observed in 15 （30%）, 10 （20%）, 4 （8%）, 7 （14%）, 4 （8%） and 10 （20%） eases respectively. The nodules that had inner and marginal signs were significantly larger than the nodules that had no inner and marginal signs （ 1.9 cm vs. 1.2 cm, P 〈 0. 001 ）. Conehtsion In pulmonary cancers confirmed by low-dose spiral CT screening, the lesions taking nodular form are more frequently seen than those taking mass form. The cancerous nodules have certain CT features.

关 键 词：肺癌普查 肺癌 体层摄影术 X线计算机 

分 类 号：R734.2[医药卫生—肿瘤] R730.44[医药卫生—临床医学]